Disputed medical diagnosis in spotlight as inquest into five deaths in WPS custody begins

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This article was published 07/11/2023 (726 days ago), so information in it may no longer be current.

The discredited concept of “excited delirium” was raised several times on the first day of an inquest into the death of five men following altercations with Winnipeg police officers — raising questions about how the court will approach the legitimacy of the so-called syndrome throughout the 17-day inquest.

The judicial inquiry began Tuesday by examining the circumstances around the death of 41-year-old Patrick Gagnon, whose teenage daughter and former partner sat in the small courtroom, which was presided over by inquest Judge Lindy Choy.

Three Winnipeg Police Service officers testified about their interactions with Gagnon, who they said had climbed onto a train in the early hours of Oct. 25, 2018, and was earlier reported to have chased the locomotive’s employees.

The officers described Gagnon as “quite scared,” “agitated” and “paranoid” and had repeatedly said he’d been “roofied.” After one officer coaxed Gagnon off the train, the officers said he would not release his grip on its ladder.

The officers described prying Gagnon’s hands off the structure and pulling him to the ground in a nearby grassy area, where he was “thrashing” and yelling.

Four officers restrained him, face down, each taking a limb.

Const. Mark Adolph, who was the first to testify Tuesday, told the court he struck Gagnon with his knee “about two to four times” to get the man to release his hands from underneath his body; Gagnon’s hands were pulled out and he was handcuffed. Shortly after, he lost consciousness.

The Independent Investigation Unit of Manitoba, the province’s police watchdog, determined in 2019 no actions of any officer “caused or contributed to the cause of (Gagnon’s) death.”

Dr. Charles Littman, the attending pathologist, determined Gagnon’s cause of death was “hypoxic ischemic brain damage due to cardiac arrest due to excited delirium due to cocaine use,” according to a portion of the autopsy report, read in court by inquest counsel Mark Lafreniere.

In recent years, excited delirium has been publicly rejected as a legitimate medical diagnosis or cause of death by every major medical association in the United States.

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The state of California recently banned the term’s use as a diagnosis or cause of death, as well as in police officers’ reports and civil litigation.

On Tuesday, Const. Jonathan Kiazyk explained the concept, noting: “There are a lot of factors that go into excited delirium.” He said Gagnon appeared in an “agitated state, intoxicated state” and “was paranoid, almost a bit delusional.”

Choy later asked Kiazyk about WPS training around excited delirium.

“You should be, honestly, taking person into custody as fast as you can to get them medical (attention),” Kiazyk responded.

Throughout the day’s testimony, Choy took an interest in the question of de-escalation. She asked each officer a version of the question: “Was it not an option to let him hold onto the railing for a few minutes until paramedics came?”

Each officer testified it was not possible, citing various risks. Each officer also referenced the unknown possibility of whether Gagnon could have gotten into the train’s engine compartment and begun to operate the transport vehicle.

Officers also indicated paramedics will not treat or approach a person unless they are controlled. “We had to get him away from the train and get him to safety,” Kiazyk said.

Choy also asked Kiazyk — who had referenced the risk with excited delirium of the person’s “heart stopping” — whether there was a de-escalation technique that could have been used, so Gagnon didn’t get so “worked up.”

He did not indicate there was.

The purpose of an inquest is two-fold: to determine the circumstances of a particular person’s death, but also to lead to recommendations that might prevent similar deaths in the future.

Asked about possible recommendations, Patrol Sgt. Craig Hodgson, who testified last on Tuesday, said: “I don’t think that we would have changed anything that we did that night,” before adding it was the “worst outcome you could have.”

Earlier in the day, Dallas Huston, Gagnon’s former partner and the mother of his now 17-year-old daughter, read a brief statement, voice crackling with emotion.

She told the court Gagnon “worked very hard” — 12-to-14-hour days, sometimes seven days a week — to provide for his daughter and he loved children, animals and his family.

“We are here today because he had a bad day — simply put,” she said, adding Gagnon “took his last breath” on the cold ground, after being subjected to an officer’s knee strikes.

The couple’s daughter “has spent the last five years trying to understand what has happened,” Huston said. She also referenced “waiting list after waiting list,” trying to obtain mental health supports for the teen.

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“I hope we can bring about some change (with this inquest) — namely for the children who are left behind,” Huston said.

Testimony related to Gagnon’s death largely concluded Tuesday. As a result of a personal matter, the last scheduled witness (a fourth WPS officer) is to testify Nov. 20.

No civilian witnesses are scheduled to testify; six civilian witnesses were interviewed by the IIU, according to the watchdog’s report into Gagnon’s death.

The five-person inquest will continue Wednesday at the Law Courts Building, where it will begin examining the 2019 death of Michael Bagot.

marsha.mcleod@freepress.mb.ca

Marsha McLeod
Investigative reporter Signal

Marsha is an investigative reporter. She joined the Free Press in 2023.

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